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Ignition Interlock Removal Authorization

The following client is authorized to have their Ignition Interlock Device removed as of the date noted below.

This form is intended for monitoring authorities to approve the removal of an Ignition Interlock device.

Please refer to the Device Removal page if you have completed your program and are attempting to have an Ignition Interlock removed from your vehicle.

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Please upload any official documentation that may be required to authorize the removal.
    Drop files here or